Employment Application

If hired, your responsibilities will include reporting to work on time, dressed
in a neat, clean and professional manner. You will be helping the library uphold
its mission to the community and are expected to provide friendly and informative
service to all visitors and customers of the library. We expect nothing less than
excellence from our employees.

* Required field

Personal Information

Last Name:*

First Name:*

Middle Initial:

Date:12/9/16

Address:*

City:*

State:*

Zip:*

Primary Phone:*

Secondary Phone:

Email Address:*

Placement Information

Position Applying For:*

Date Available to Start:*

Location:*(Check all that apply)
Central

East

McCollough

North Park

Oaklyn

Red Bank

Stringtown

West

Salary or Wage Desired:*

Interested in:*Full Time

Part Time

Temporary

I was referred to Evansville Vanderburgh Public Library by:

Advertisement

Walk-in

Employment Agency

Friend/Relative

Library Website

Other

Have you ever applied or been employed by the EVPL before?

Applied?*YesNo

Employed?*YesNo

Do you have relatives or friends that are employed by the EVPL?*

YesNo

Are you at least 18 years or older? If no, you may be required to
provide authorization to work.*

YesNo

Can you travel if a job requires it?*

YesNo

Are you legally authorized or permitted to work in the United States?
Documents which establish identity & employment eligibility will be required
upon employment.*

YesNo

Have you ever been arrested for or convicted of a crime that has not been expunged by a court? Answering yes to this question does not necessarily disqualify you from employment.*

YesNo

Can you perform all of the essential functions of the job as stated in the job posting for
which you are applying, with or without reasonable accommodation? (If you have any questions about the job's functions,
please speak with an EVPL representative before answering the question.)*

Occupational References

Provide three references who are not related to you and are knowledgeable of your
professional work.

Name*

Company*

Job Title*

Telephone Number*

Email Address

1.

2.

3.

Employment Experience

Include any job-related military service assignments and volunteer activities. You
may exclude organizations which indicate race, color, religion, gender, national
origin, handicap, or other protected status.

Attachments

Applicants may attach up to three documents (i.e. resume, cover letter, etc) to
an application. We accept Word (.doc or .docx) and PDF files. Maximum size for each
file is 4MB.

You'll be able to attach files on the next page.

Applicant's Statement

The Evansville Vanderburgh Public Library is an equal opportunity employer and does
not discriminate in employment on account of race, color, religion, national origin,
citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation,
marital status, physical or mental disability, or military status.

I understand that neither the completion of this application nor any other part
of my consideration for employment establishes any obligation for Evansville Vanderburgh
Public Library to hire me. If I am hired, I understand that either Evansville Vanderburgh
Public Library or I can terminate my employment at any time and for any reason,
with or without cause, and without prior notice. I understand that no representative
of Evansville Vanderburgh Public Library has the authority to make any assurance
to the contrary.

I,
(please type your name)*, by putting my electronic signature certify
that I have made true, correct and complete answers and statements on this application
in the knowledge that they may be relied upon in considering my application. I understand
that any omission, false answered statements made by me on this application, or
any supplement to it will be sufficient cause for failure to employ or for my discharge
should I become employed with the Evansville Vanderburgh Public Library. I hereby
voluntarily consent to the Evansville Vanderburgh Public Library, or any of its
officers or employees, to check my references by contacting any person whom it deems
to be an appropriate reference. This application will be kept in an active file
for a period of three (3) months and then archived.

Employment Screening Policy

Applicant Authorization and Consent for Release of Information

Evansville Vanderburgh Public Library requires, as a condition
of employment, and/or continued employment that all applicants consent to and authorize
a verification of the information submitted on their application or resume. Please read this statement
carefully.

DISCLOSURE REGARDING BACKGROUND INVESTIGATION

I,
(please type your name)*, by putting my electronic signature consent the Evansville Vanderburgh Public Library (“the Company”) may obtain information about you from a third party consumer reporting agency for employment purposes. This information may be obtained in the form of a “consumer report” and/or an “investigative consumer report” (commonly known as a “background report”). These reports may contain information regarding your criminal history, social security verification, motor vehicle records (“driving records”), credit history*, verification of your education or employment history, or other background checks. This information may be obtained from private and public record sources, including, as appropriate: government agencies and courthouses and educational institutions. The reports may also include information about your character, general reputation, personal characteristics, mode of living, etc., which can involve personal interviews with individuals or companies that you have listed as a reference, former employer, etc. A more comprehensive background investigation may be required pursuant to state or federal law, contract agreement or for certain sensitive positions (such as those with significant financial responsibilities). (*Please note that credit history will only be requested where such information is substantially related to the duties and responsibilities of the position for which you are applying.)

A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT

You have the right, upon written request made within a reasonable time, to request whether a consumer report has been run about you, disclosure of the nature and scope of any investigative consumer report and to request a copy of your report. Please be advised that the nature and scope of any investigative consumer report obtained with regard to applicants for employment is an investigation conducted by Reference Services, Inc. (RSI). RSI is located and can be contacted by mail at 101 Plaza East Blvd, Suite 300, Evansville, IN 47715, and RSI can be contacted by phone at (800)881-0754. Information about RSI’s privacy policy is available at the following link: http://www.referenceservices.com/wp-content/uploads/2013/09/RSI-Consumer-Information-Privacy-Policy.pdf. The scope of this notice and authorization is all-encompassing and allows the Company to obtain from any outside organization all manner of consumer reports throughout the course of your employment or your contract period to the extent permitted by law.

ACKNOWLEDGMENT AND AUTHORIZATION FOR BACKGROUND CHECK

I acknowledge receipt of the information entitled “DISCLOSURE REGARDING BACKGROUND INVESTIGATION” and “A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT” (above) and certify that I have read and understand both of those documents. I hereby authorize the obtaining of “consumer reports” and/or “investigative consumer reports” by the Company at any time after receipt of this authorization and throughout my employment, or status as and Advisor, if applicable. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information requested by Reference Services, Inc. [101 Plaza East Blvd, Suite 300, Evansville, IN 47715, (800)881-0754, www.referenceservices.com] and/or the Company itself. I agree that a facsimile (“fax”), electronic or photographic copy of this Authorization shall be as valid as the original.

New York applicants only: Upon request, you will be informed whether or not a consumer report was requested by the Company, and if such report was requested, informed of the name and address of the consumer reporting agency that furnished the report. You have the right to inspect and receive a copy of any investigative consumer report requested by the Company by contacting the consumer reporting agency identified above directly. By signing below, you acknowledge receipt of Article 23-A of the New York Correction Law

Washington State applicants only: You also have the right to request from the consumer reporting agency a written summary of your rights and remedies under the Washington Fair Credit Reporting Act.

Minnesota and Oklahoma applicants only:
Please check this box if you would like to receive a copy of a consumer report if one is obtained by the Company.

California applicants only:
Under California Civil Code section 1786.22, you are entitled to find out what is in the CRA’s file on you with proper identification, as follows:

In person, by visual inspection of your file during normal business hours and on reasonable notice. You also may request a copy of the information in person. The CRA may not charge you more than the actual copying costs for providing you with a copy of your file.

A summary of all information contained in the CRA file on you that is required to be provided by the California Civil Code will be provided to you via telephone, if you have made a written request, with proper identification, for telephone disclosure, and the toll charge, if any, for the telephone call is prepaid by or charged directly to you.

By requesting a copy be sent to a specified addressee by certified mail. CRAs complying with requests for certified mailings shall not be liable for disclosures to third parties caused by mishandling of mail after such mailings leave the CRAs.

“Proper Identification” includes documents such as a valid driver’s license, social security account number, military identification card, and credit cards. Only if you cannot identify yourself with such information may the CRA require additional information concerning your employment and personal or family history in order to verify your identity. The CRA will provide trained personnel to explain any information furnished to you and will provide a written explanation of any coded information contained in files maintained on you. This written explanation will be provided whenever a file is provided to you for visual inspection. You may be accompanied by one other person of your choosing, who must furnish reasonable identification. A CRA may require you to furnish a written statement granting permission to the CRA to discuss your file in such person’s presence.

Please check this box if you would like to receive a copy of an investigative consumer report or consumer credit report at no charge if one is obtained by the Company whenever you have a right to receive such a copy under California law.

Please provide all requested information and provide addresses for the last seven
(7) years.